Developing a Mindfulness Movement Intervention Program for Post-MI Patients

为心肌梗死后患者制定正念运动干预计划

基本信息

批准号：
8738611
负责人：
Laura S Redwine
金额：
$ 16.88万
依托单位：
VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-30 至 2017-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8738611
关键词：
Adherence Aerobic Exercise Affect Aftercare Age American American Heart Association Angina Pectoris Behavior Therapy Behavioral Bicycling Biological Markers Blood Pressure Breathing Calculi Cardiac Cardiac rehabilitation Cardiovascular system Chest Pain Clinical assessments Comorbidity Data Development Diet Disease Disease Progression Distant Echocardiography Elderly Enrollment Equipment Ergometry Event Exercise Exploratory/Developmental Grant Fatigue Feasibility Studies Frequencies Future Goals Health behavior Heart Rate Heart failure Home environment Inflammatory Intervention Investigation Lead Light Literature Location Measures Mediation Medical center Mental Depression Mental Health Metabolic Minority Movement Myocardial Myocardial Infarction Oxygen Consumption Participant Patient Recruitments Patients Personal Satisfaction Physical Function Physical activity Protein C Inhibitor Psychological Factors Pump Quality of life Randomized Recovery Recruitment Activity Recurrence Rehabilitation therapy Reporting Research Risk Factors Services Shortness of Breath Sleep Special Equipment Speed Stress Symptoms Tai Ji Task Performances Techniques Testing Time Training Travel Treatment Effectiveness United States National Institutes of Health Visit Walking Woman Work anakinra arm base cardiovascular risk factor clinical care cohort depressive symptoms ethnic minority population expectation experience fitness follow-up improved innovation interest intervention program medication compliance meetings men mindfulness outcome forecast programs psychologic psychosocial public health relevance satisfaction sedentary standard of care tool treatment adherence trend

项目摘要

DESCRIPTION (provided by applicant): Each year around 785,000 Americans endure a first myocardial infarction (MI) and 470,000 will have a recurrent event. The American Heart Association (AHA) recommends exercise-based cardiac rehabilitation (CR) for reductions in subsequent cardiac events. Despite the benefits of CR, only 14-35% of eligible MI patients participate in CR. Patients with co-morbidities, women, older adults, and ethnic minorities are least likely to utilize CR services. Many medical centers do not have CR programs and patients have to travel to distant locations to undergo CR. In turn, many Tai Chi interventions, have been studied in elderly cohorts, require no expensive equipment, can be practiced at home, and is well tolerated across fitness levels, and co-morbidities. Tai Chi increases heart rate (56% to 65% of maximum), oxygen consumption and lactate accumulation, signifying that Tai Chi serves as an aerobic exercise of low to moderate intensity. However, no Tai Chi studies in post-MI patients have employed state-of-the-art measures of cardiac function and exercise capacity and therefore it is unclear whether Tai Chi has similar benefits as CR during a period of myocardial recovery. The proposed study would employ tools including echocardiograms, heart rate recovery, and bicycle ergometry, which have been used in many CR studies to assess the effectiveness of treatment. This study is also innovative in that it specifically targets patients who have not opted to participate in a formal CR program within 30 days of a first-time MI and emphasizes recruitment of patients spanning an older age range, physical function ability, women and minorities. A total of 75 men and women with a first time MI will be randomly assigned to 4 months of Tai Chi training composed of 20 meditative movements or to standard of care (SOC). Clinical assessments will be performed over a six-month period, with testing occurring before, mid-way, and after 4 months of treatments, and at an 8 week follow-up. Our current goal is to gather preliminary data on study feasibility, acceptability and to find indicatins of improvements in physical, cardiac and psychological/behavioral factors. If the aims are met from this exploratory/development study, a future large scale study will be undertaken to confirm Tai Chi's efficacy in post-MI patients. Such research is critically needed so adequate rehabilitative interventions can be developed for diverse MI patients.

描述（由申请人提供）：每年约有 785,000 名美国人经历首次心肌梗塞 (MI)，其中 470,000 人会复发。美国心脏协会 (AHA) 建议进行基于运动的心脏康复 (CR)，以减少随后的心脏事件。尽管 CR 有诸多好处，但只有 14-35% 符合条件的 MI 患者参与 CR。患有合并症的患者、女性、老年人和少数民族最不可能利用 CR 服务。许多医疗中心没有 CR 项目，患者必须前往遥远的地方接受 CR。反过来，许多太极拳干预措施已经在老年人群中进行了研究，不需要昂贵的设备，可以在家练习，并且在不同的健康水平和合并症中具有良好的耐受性。太极拳会增加心率（最高心率的56%至65%）、耗氧量和乳酸积累，这表明太极拳是一种低至中等强度的有氧运动。然而，还没有针对心肌梗死后患者的太极拳研究采用最先进的心脏功能和运动能力测量方法，因此尚不清楚太极拳在心肌恢复期间是否具有与 CR 类似的益处。拟议的研究将采用超声心动图、心率恢复和自行车测力等工具，这些工具已在许多 CR 研究中用于评估治疗的有效性。这项研究的创新之处还在于，它专门针对首次心梗后 30 天内未选择参加正式 CR 计划的患者，并强调招募年龄范围较大、身体功能能力强、女性和少数族裔的患者。总共 75 名首次心肌梗死的男性和女性将被随机分配接受为期 4 个月的太极训练（包括 20 个冥想动作）或接受标准护理 (SOC)。临床评估将在六个月的时间内进行，测试将在治疗前、治疗中、治疗后 4 个月以及 8 周的随访中进行。我们当前的目标是收集有关研究可行性、可接受性的初步数据，并寻找身体、心脏和心理/行为因素改善的迹象。如果这项探索性/发展研究的目标得以实现，未来将进行一项大规模研究，以证实太极拳对心肌梗死后患者的疗效。迫切需要此类研究，以便为不同的心肌梗死患者制定适当的康复干预措施。